Pairing of improper complaint codes with legal proceeding codes will result in non-payment. “Up-coding” of legal proceedings shall constitute grounds for prosecution with some additional fines imposed by the IRS, as determined by the Office of Health and Human Services. For instance, pairing a legal complaint of “Spilling, Coffee, Hot, with blisters” to and of those of Divorce, same gender, living apart, male (or female) (shown below) will result in non-payment.

This cracked me up. Seeing this this way pointed out even more vividly how ridiculous our system is.

This kind of complex payment system for lawyers would't happen until "legal insurance" and government run "Legalcare" and "Legalcaid" become more widespread. I think the lawyers are smart enough not to take this kind of crap, unlike us docs...

DrWes -- Funny, but you may be interested to know that this system already exists in the legal world, largely for outside counsel to insurance companies (particularly those other than health insurance companies) -- complete with bill reviews by computer programs, etc. As some physicians are now doing, most lawyers have opted for private pay relationships with most clients. Some lawyers have come around to flat fee or other alternative billing arrangements, which can work well for both lawyers and clients if well-designed. The legal payment system and the health care payment system have more similarities than you might think, and the legal "establishment" is undergoing its own dislocation these days, too. Bottom line: value-based purchasing isn't limited to the health care arena. Just sayin'.

I am constantly amazed at what one can learn from a blog. Thanks for educating me.

I wonder if doctors will follow lawyers' lead? If Medicare didn't have the two-year restriction to dropping out of the system (placed there by whom?), I bet many more would have opted out from this craziness long ago.

1.I still am waiting the first Law School in India to prepare young Indian attorneys to practice in the USA. Then, after a certain threshold of foreign-trained attorneys have increased the supply of lawyers, there will be a real chance to introduce sweeping changes to The Legal Care Industry. 2.If doctors billed like lawyers? How about $5000 retainer and $325/hour?

But, what if doctors billed like lawyers? A 5K retainer from which charges of $325/hour are deducted until a new retainer is required?

When India opens its first American-Law Law School and churns out thousands of Bar ready attorneys, then we will see such legislation as USPDA. Foreign attorneys will be so well paid in comparison to their peers back home that they would slavishly accept almost any degree of bureaucratic bullying. Hey, I wonder if that was The Plan in Medicine?Then the "Legal Care Providers" can be marched into a USPDA.

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.